Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
40� City of Orono FOR CITY USE ONLY <br /> o P.O.Box 66 <br /> ` 2750 Kelley Parkway Date Received: Permit# <br /> 7 Crystal Bay, MN 55323 <br /> (952)249-4600 Amount: $ <br /> t'ersxoe <br /> CITY OF ORONO — SEPTIC SYSTEM PERMIT APPLICATION <br /> (All permits must be approved by the On-Site Septic Manager and/or Building Official) <br /> Site Address: <br /> Owner: O-ZZ &✓ue-L5- Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information: r <br /> Contractor/App.:Ad✓OtWc L Xlc<ve Contact Person: hP Oi°l G <br /> Address: ���r`� ("o Ad 3State License #: 17 <br /> City: / Zip: (7'y'X7 Expiration Date: <br /> Phone: 612-3OS Alternate Phone: <br /> Residential ❑ Commercial ❑ Other <br /> New or Replacement System $200.00 ? / <br /> Repair Existing System 100.00 <br /> (Tanks or Drainfield) <br /> State Surcharge .50 .50 <br /> Total $ �G°Ci.. �j`�_/ <br /> V:\(Permits)\Septic Permit Application-New Permit Fees 2009.doc <br /> 1 / 2 <br />